Fulminant Epstein-Barr virus (EBV)-associated T-cell lymphoproliferative disorder with hemophagocytosis following autologous peripheral blood stem cell transplantation for relapsed angioimmunoblastic T-cell lymphoma

Norihiro Awaya, Akiko Adachi, Taisuke Mori, Hiroshi Kamata, Jin Nakahara, Kenji Yokoyama, Taketo Yamada, Masahiro Kizaki, Michiie Sakamoto, Yasuo Ikeda, Shin ichiro Okamoto

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Abstract

Post-transplant lymphoproliferative disorder (PTLD) is a complication that can develop after either solid-organ or hematopoietic stem cell transplantation (HSCT). T-cell PTLD is a rare disorder, especially following autologous HSCT. Here we report a case of T-cell PTLD which occurred after autologous peripheral blood stem cell transplantation (PBSCT) for relapsed angioimmunoblastic T-cell lymphoma (AILT). Three months after the transplant, the patient developed fever with elevated plasma Epstein-Barr virus (EBV)-PCR values. The patient subsequently developed pneumonitis, hepatomegaly and marked pancytopenia due to hemophagocytosis. The patient died of multi-organ failure, despite antiviral and steroid pulse therapy. Our post-mortem study confirmed the marked proliferation of EBV-infected T-cells that differed from the original AILT clone and macrophages/histiocytes were observed in the marrow, liver, lymph nodes and lungs. Phagocytosis was most evident in the bone marrow. The patient's AILT remained in complete remission. To the best of our knowledge, this is the first case of fulminant EBV-associated T-cell lymphoproliferative disorder (LPD) following autologous HSCT.

Original languageEnglish
Pages (from-to)1059-1062
Number of pages4
JournalLeukemia Research
Volume30
Issue number8
DOIs
Publication statusPublished - 2006 Aug 1

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Keywords

  • Angioimmunoblastic T-cell lymphoma
  • Autologous peripheral blood stem cell transplantation
  • Epstein-Barr virus
  • Hemophagocytosis
  • T-cell lymphoproliferative disorder

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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